中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 37 Issue 7
Jul.  2021
Turn off MathJax
Article Contents

Clinical follow-up of children with immune-tolerant chronic hepatitis B receiving antiviral therapy

DOI: 10.3969/j.issn.1001-5256.2021.07.016
Research funding:

Beijing Municipal Science and Technology Commission (Z181100001718035);

National Natural Science Foundation of China (81501652);

Municipal Natural Science Foundation of Beijing of China (7202193)

  • Received Date: 2021-01-28
  • Accepted Date: 2021-02-23
  • Published Date: 2021-07-20
  •   Objective  To investigate the long-term clinical benefits of antiviral therapy in children with immune-tolerant chronic hepatitis B.  Methods  Long-term follow-up was performed for 46 children with immune-tolerant chronic hepatitis B who were enrolled in the treatment group of the previous randomized controlled trial, and clinical evaluation was performed at weeks 108, 120, 132, 144, 168, and 192 after the trial started.  Results  All 46 patients completed the follow-up. From week 96 (after the clinical trial started) to week 192 (when the follow-up ended), another 3 patients achieved serum HBV DNA clearance, another 7 patients achieved serum HBeAg clearance, another 6 patients achieved HBeAg seroconversion, and another 3 patients achieved HBsAg seroconversion, while there was no change in the number of patients who achieved serum HBsAg clearance, with a total number of 37 (80.4%), 22 (47.8%), 21 (45.7%), 10(21.7%), and 10(21.7%), respectively. Among these patients, 9(19.6%) did not achieve HBV DNA clearance and they all had virologic breakthrough after drug withdrawal.  Conclusion  Further large-sample clinical trials are needed to investigate antiviral therapy for children with immune-tolerant chronic hepatitis B.

     

  • loading
  • [1]
    CHOI GH, KIM GA, CHOI J, et al. High risk of clinical events in untreated HBeAg-negative chronic hepatitis B patients with high viral load and no significant ALT elevation[J]. Aliment Pharmacol Ther, 2019, 50(2): 215-226. DOI: 10.1111/apt.15311.
    [2]
    LIM JK, NGUYEN MH, KIM WR, et al. Prevalence of chronic hepatitis B virus infection in the United States[J]. Am J Gastroenterol, 2020, 115(9): 1429-1438. DOI: 10.14309/ajg.0000000000000651.
    [3]
    NASTASIO S, JONAS MM. Effect of universal infant hepatitis B virus immunization on mother-to-child hepatitis B virus transmission[J]. J Infect Dis, 2019, 220(7): 1089-1090. DOI: 10.1093/infdis/jiy707.
    [4]
    Polaris Observatory Collaborators. Global prevalence, treatment, and prevention of hepatitis B virus infection in 2016: A modelling study[J]. Lancet Gastroenterol Hepatol, 2018, 3(6): 383-403. DOI: 10.1016/S2468-1253(18)30056-6.
    [5]
    DELLA CORTE C, NOBILI V, COMPARCOLA D, et al. Management of chronic hepatitis B in children: An unresolved issue[J]. J Gastroenterol Hepatol, 2014, 29(5): 912-919. DOI: 10.1111/jgh.12550.
    [6]
    ZHU S, ZHANG H, DONG Y, et al. Antiviral therapy in hepatitis B virus-infected children with immune-tolerant characteristics: A pilot open-label randomized study[J]. J Hepatol, 2018, 68(6): 1123-1128. DOI: 10.1016/j.jhep.2018.01.037.
    [7]
    ZHAO P, ZHONG YW, XU DP. A181 site mutation in HBV reverse transcriptase region on chronic HBV-infected patients during Entecavir therapy[J]. J Clin Hepatol, 2011, 27(3): 289-291. DOI: 10.3969/j.issn.1001-5256.2011.03.020.

    赵攀, 钟彦伟, 徐东平. 5例应用恩替卡韦治疗的慢性HBV感染者发生HBV逆转录酶区单独A181位点突变的分析[J]. 临床肝胆病杂志, 2011, 27(3): 289-291. DOI: 10.3969/j.issn.1001-5256.2011.03.020.
    [8]
    MARTIN P. Immune-tolerant hepatitis B: Maybe a misnomer but still hard to treat[J]. Hepatology, 2019, 69(6): 2315-2317. DOI: 10.1002/hep.30654.
    [9]
    HSU YC, HUANG YT. Editorial: Risk assessment for chronic hepatitis B patients in the immune tolerant phase-both definition and selection matter[J]. Aliment Pharmacol Ther, 2020, 52(1): 213-214. DOI: 10.1111/apt.15798.
    [10]
    INDOLFI G, EASTERBROOK P, DUSHEIKO G, et al. Hepatitis B virus infection in children and adolescents[J]. Lancet Gastroenterol Hepatol, 2019, 4(6): 466-476. DOI: 10.1016/S2468-1253(19)30042-1.
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(1)  / Tables(1)

    Article Metrics

    Article views (652) PDF downloads(69) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return